Trichomoniasis

Overview

Trichomoniasis ("trich") is caused by a parasite that passes during sex. It is one of the most common curable STIs.

Without treatment, it can last for months or years. It raises the risk of getting or spreading other STIs, including HIV, and can cause problems in pregnancy.

Symptoms

Most people have no symptoms. Symptoms may start 5 to 28 days after infection, or much later.

• Unusual vaginal discharge (clear, white, yellow, or green)
• Genital itching, burning, redness, or soreness
• Fishy or unusual odor
• Discharge from the penis, or itching inside the penis

Less common

• Burning when urinating
• Burning after ejaculation
• Pain during sex

How it usually goes

• 5 to 28 days: Symptoms may start, if any.
• Untreated: Can last months or years.
• 3 months after treatment: Women should retest.

When to get medical care

Causes

Trich is caused by the parasite Trichomonas vaginalis. It spreads during sex, from penis to vagina, vagina to penis, or vagina to vagina.

Does it spread or run in families?

• Yes, it can spread from person to person.
• How it spreads: sex.
• Condoms lower the risk. Sex partners should be tested and treated too.

Who is more likely to get it

• More than one partner
• Not using condoms
• Having had an STI before

Possible complications

• HIV: Trich raises the risk of getting or spreading HIV
• Bacterial vaginosis: Often found together

Diagnosis

Trich is found with a lab test.

Questions you may be asked

• What the discharge looks and smells like
• Itching, burning, or pain during sex
• Recent partners
• Whether you could be pregnant

The exam

They may check your genitals and do a pelvic exam.

Tests

Testing is quick:

• Swab or urine test: Looks for the parasite.
• Tests for other STIs: Including chlamydia, gonorrhea, syphilis, and HIV.

Treatment

Trich is cured with prescription pills. Partners must be treated too.

Self-care

• Take all of your pills
• Don't drink alcohol during treatment and for at least a day after (3 days after tinidazole)
• Don't have sex until you and your partners finish treatment and symptoms are gone
• Get retested in 3 months (women), since reinfection is common

Medicines

These need a prescription.

Vaginal gel doesn't work for trich. Pills are needed.

If it comes back and you haven't been reexposed, a longer or stronger course may be needed.

How it compares

Prevention

You can lower your risk:

• Use condoms correctly every time
• Make sure partners are treated before having sex again
• Limit your number of partners
• Get tested if you have symptoms

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a sexual health clinic, an OB-GYN, or a urologist; your local health department can test for free or low cost.

Back to school, work, or sports

• You can go to school and work as usual.
• Don't have sex until you and your partners finish treatment and your doctor says it's OK.

Children, pregnancy, and older adults

• Pregnancy: Trich can lead to early birth or a small baby. Metronidazole is safe in pregnancy.
• Breastfeeding: Ask whether to pause breastfeeding after a single large dose.
• Men: Usually have no symptoms but can still spread it.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Some infections can pass to the baby during pregnancy or birth. Tell your provider if you've been exposed.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Trich is easy to cure, but about 1 in 5 people get it again within 3 months. Treating partners helps prevent this.

Getting ready for your visit

Tell them about all recent partners.

What to bring

• Your symptoms and when they started
• Whether you could be pregnant
• Any allergies to medicines

Questions to ask

• Do my partners need treatment?
• Can I drink alcohol on this medicine?
• Should I be tested for other STIs?
• When should I retest?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Trichomoniasis